Impact of BRCA mutations and hormone receptor status on reproductive potential in breast cancer patients undergoing fertility preservation

Abstract

Objective

To identify whether the BRCA mutations and hormone receptor status affect the ovarian reserve and ovarian stimulation outcomes in breast cancer patients undergoing fertility preservation.

Methods

A total of 117 women diagnosed with breast cancer who were referred to the fertility preservation clinics at Seoul National University Bundang Hospital and Seoul National University Hospital between September 2012 and July 2019 undergone ovarian stimulation for oocyte retrieval. Basal characteristics including age, BMI, basal AMH, basal FSH, and fertility preservation outcomes such as the number of retrieved oocytes and mature oocytes were compared retrospectively.

Results

BRCA1 mutation was noted in 25 women, and BRCA2 mutation was observed in 35 women. Positive estrogen receptor status was noted in 87 women, and positive progesterone receptor status was noted in 69 women. HER2 was positive in 55 women, and 19 women were diagnosed with triple-negative breast cancers. The number of total oocytes retrieved was lower in patients with BRCA mutation (8.3 ± 5.4 vs. 15.3 ± 8.7, p = .002). The number of mature oocytes retrieved was also lower in BRCA carriers (4.7 ± 4.2 vs. 8.7 ± 7.9, p = .025). Triple-negative breast cancer (TNBC) patients were younger than non-TNBC patients (30.3 ± 4.8 vs. 33.9 ± 5.0, p = .007). The rate of mature oocyte rate was higher in TNBC patients (68.6%±20.6 vs. 52.5%±29.7, p = .037).

Conclusions

Our study demonstrated that BRCA carriers with breast cancer had comparable ovarian reserve to non-carriers but the response to ovarian stimulation was lower. We also observed that oocyte maturity was higher in TNBC patients, however age might be a confounding factor of this result.

BRCA突变和激素受体状态对正在接受生育力保护的乳腺癌患者生殖潜能的影响 摘要

目的：确定BRCA突变和激素受体状态是否影响正在接受生育力保护的乳腺癌患者的卵巢储备和卵巢促排结局。

方法：在、2012年9月至2019年7月期间, 共有117名被诊断为乳腺癌的女性在首尔国立大学本当医院和首尔国立大学医院的生育保存诊所接受了卵巢促排取卵。回顾性比较基线情况, 包括年龄、BMI、基础AMH、基础FSH, 以及生育力保护结局, 如获卵数和成熟卵泡的数量。

结果：在25名女性中发现BRCA1突变, 在35名女性中观察到BRCA2突变。87名女性雌激素受体阳性, 69名女性孕激素受体阳性。55名女性HER2呈阳性, 19名女性被诊断为三阴性乳腺癌。BRCA突变患者获卵数较低（8.3±5.4:15.3±8.7, p=0.002）。BRCA突变携带者取卵数也较低（4.7±4.2:8.7±7.9, p=0.025）。三阴性乳腺癌（TNBC）患者比非TNBC患者年轻（30.3±4.8:33.9±5.0, p=0.007）。TNBC患者的卵泡成熟率较高（68.6%±20.6:52.5%±29.7, p=0.037）。

结论：本研究表明, 乳腺癌BRCA突变携带者的卵巢储备与非携带者相当, 但对卵巢刺激反应较低。我们还观察到TNBC患者的卵泡成熟度较高, 但年龄可能是这一结局的混杂因素。

Keywords:

• Breast cancer
• BRCA1
• BRCA2;triple negative breast cancer
• fertility preservation

Acknowledgments

This study has not been presented elsewhere.

Disclosure statement

No potential conflict of interest was reported by the authors.